MEDICARE: THAO T PHAM PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26031914A	IN

General Provider Information

NPI Number	:	1831022367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THAO T PHAM PHARMD

Provider Business Mailing Address
First Line	:	915 S MERIDIAN ST APT 634
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46225-1318
Country	:	US
Telephone Number	:	857-919-7862
Fax Number	:

Provider Business Practice Location Address
First Line	:	5026 W US 52
Second Line	:
City	:	NEW PALESTINE
State	:	IN
Zip	:	46163-9770
Country	:	US
Telephone Number	:	317-861-4838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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